PAY IN SLIP BANK'S COPY PAY IN SLIP GPAT'S COPY PAY IN SLIP CANDIDATE'S COPY

_____________________________ BRANCH (SOL Id. * _______________ _____________________________ BRANCH (SOL Id.* ______________ ___________________________ BRANCH (SOL Id. * ____________
(Write the Branch name and SOL Id.) (Write the Branch name and SOL Id.) (Write the Branch name and SOL Id.)
(GPAT-2011 Online Application Fee Payment Details) (GPAT-2011 Online Application Fee Payment Details) (GPAT-2011 Online Application Fee Payment Details)
GPAT-2011 FEE COLLECTION A/C NO. 02010100019073 GPAT-2011 FEE COLLECTION A/C NO. 02010100019073 GPAT-2011 FEE COLLECTION A/C NO. 02010100019073
UNIVERSITY CAMPUS M.S.University, Baroda (CODE: MSUNIV) UNIVERSITY CAMPUS M.S.University, Baroda (CODE: MSUNIV) UNIVERSITY CAMPUS M.S.University, Baroda (CODE: MSUNIV)
Name of the Candidate : MANJUNATH Name of the Candidate : MANJUNATH Name of the Candidate : MANJUNATH
Present Address : MANJUNATH S/0 KALAKAPPA Present Address : MANJUNATH S/0 KALAKAPPA Present Address : MANJUNATH S/0 KALAKAPPA
: I B GARDEN BEHIND POST OFFICE : I B GARDEN BEHIND POST OFFICE : I B GARDEN BEHIND POST OFFICE
: SIRWAR TQ: MANVI DST:RAICHUR : SIRWAR TQ: MANVI DST:RAICHUR : SIRWAR TQ: MANVI DST:RAICHUR
: SIRWAR 584129 : SIRWAR 584129 : SIRWAR 584129
Mobile/ Landline No : 9945750571 ,08538251014 Mobile/ Landline No : 9945750571 ,08538251014 Mobile/ Landline No : 9945750571 ,08538251014
E-mail Address : manju33sirwar@gmail.com E-mail Address : manju33sirwar@gmail.com E-mail Address : manju33sirwar@gmail.com
Category : GEN Category : GEN Category : GEN
Physically Disabled : NO Physically Disabled : NO Physically Disabled : NO

Head Amount Credit to Head Amount Credit to Head Amount Credit to

Application Fee Rs. 990 02010100019073 Application Fee Rs. 990 02010100019073 Application Fee Rs. 990 02010100019073

Bank's Fee Rs. 10 Bank's Fee Rs. 10 Bank's Fee Rs. 10

Total Rs.1000 Total Rs.1000 Total Rs.1000

Amount in words : Rs. One thousand only Amount in words : Rs. One thousand only Amount in words : Rs. One thousand only

Signature of the Candidate/Remitter Signature of the Candidate/Remitter Signature of the Candidate/Remitter

For Receiving Branch use only For Receiving Branch use only For Receiving Branch use only

APPLICATION NUMBER TRANSACTION NUMBER * APPLICATION NUMBER TRANSACTION NUMBER * APPLICATION NUMBER TRANSACTION NUMBER *

134983 134983 134983

1. Please credit Rs.10/- to your Branch Commission A/c No. 1. Please credit Rs.10/- to your Branch Commission A/c No. 1. Please credit Rs.10/- to your Branch Commission A/c No.
2. Please note to write the TRANSACTION Number in all the challans. 2. Please note to write the TRANSACTION Number in all the challans. 2. Please note to write the TRANSACTION Number in all the challans.
3. PAYABLE AT ALL BRANCHES OF BANK OF BARODA 3. PAYABLE AT ALL BRANCHES OF BANK OF BARODA 3. PAYABLE AT ALL BRANCHES OF BANK OF BARODA
* To be filled by Bank Staff * To be filled by Bank Staff * To be filled by Bank Staff

SEAL / DATE AUTHORISED SIGNATORY SEAL / DATE AUTHORISED SIGNATORY SEAL / DATE AUTHORISED SIGNATORY